Today is World AIDS Day, when people around the globe stop to reflect on those lost to the HIV/AIDS epidemic, which is almost in its third decade. While many people may associate the disease with white, gay men because they were one of the groups initially infected and affected by HIV and among the most political vocal about it, the fact is the epidemic has changed. Within the U.S., if you examine the epidemic across racial and ethnic groups, you will see that HIV/AIDS is not a disease that exclusively, or even primarily, affects whites. Blacks and Latinos are increasingly affected by the disease, as this graph based on 2007 CDC statistics illustrates:
The changing nature of the epidemic is even more striking when you include gender.Today, black women are the group with the highest rates of new HIV/AIDS infections. According to CDC:
- African American women account for a majority of new AIDS cases (66% in 2006); white women and Latina women account for 17% and 16% of new AIDS cases, respectively.
- African American women account for the largest share of new HIV infections among women (61% in 2006), an incidence rate nearly 15 times the rate among white women. (For more detailed look at statistics about the epidemic’s impact on African Americans, see: “Black Americans and HIV/AIDS” compiled by the Kaiser Family Foundation, opens PDF.)
During the first decade of the epidemic, most social science research focused on changing individual behavior (e.g., wearing condoms, using clean needles) as the primary intervention strategy to prevent HIV infection, these efforts often failed in the face of complex settings of social inequality. For example, telling a woman that her partner should wear a condom becomes a risky proposition if she is economically dependent on that man for survival and he sees the request to wear a condom as an affront of some kind. Thus, researchers and community activists interested in stopping the spread of the disease began to look at the dynamics of sexuality within a broader social and cultural factors.
Just as an increasing amount of research demonstrates that mothers who experience racism are more likely to have low-birth-weight babies, the experience of racism and sexism are part of the social and cultural factors affecting HIV/AIDS rates among African American women. One way to measure this combined racism and sexism, is to look at what national leaders have to say about the HIV/AIDS epidemic among black women. In 2004, when journalist and vice-presidential debate moderator Gwen Ifill raised this important issue in the form of a question to then-candidates John Edwards and Dick Cheney, neither one could stammer out a coherent answer. It was clear that the alarming rates of HIV/AIDS among black women were simply not a concern for powerful political leaders (who also happened to be white men).
Some of the most exciting research that attempts to address this inequality is the pioneering intervention studies conducted by Gina Wingood and Ralph DiClemente of Emory University who, drawing on Connell’s gender and power theory, began to think differently about HIV prevention for young, black women. Wingood and DiClemente developed an intervention study for African American adolescent girls that used workshops that emphasized ethnic and gender pride along with the usual HIV-prevention information. Basically, the researchers included a consciousness-raising group about race and gender along with the usual health education information. These positive messages about racial and gender pride are important for enabling and empowering young, black women who encounter a layered burden of racism, sexism and often, poverty.
However, not all black women who are HIV-infected are poor, as several activists remind us. Marvelyn Brown, for example, diagnosed at age 19 with HIV/AIDS has become an outspoken proponent and visible spokesperson for HIV-prevention among young, black women. The author of Naked Truth: Young, Beautiful and (HIV) Positive, Brown has won several awards for her activism. Rae Lewis-Thornton, diagnosed at age 23, was featured on the cover of Essence magazine in 1994 and described as, “I’m young, I’m educated, I’m drug-free, and I’m dying of AIDS.” It’s been fifteen years and, fortunately, Lewis-Thornton is still very much alive and an tireless activist. Yet, she struggles with the legacy of her diagnosis (powerful video interview with Lewis-Thornton here). And, young black women who are allies, are harnessing the power of new media to raise awareness about HIV/AIDS, such as Karyn and Luvvie of the Red Pump Project.
The growing epidemic among black women in the U.S. reflects a global trend. The World Health Organization’s estimate (via AIDS.org) is that there are over three million women with HIV in the world, most of them in Africa. In fact, one in 50 women in sub-Saharan Africa is infected with HIV. AIDS is the leading cause of death for women ages 20-40 in major
cities in the Americas, Western Europe, and Africa. The fact that this disease is shape-shifting into one what disproportionately affects black women both here in the U.S. and globally raises important questions about whether or not we will, collectively, be able to put aside our racism (and sexism) to address this epidemic.
As you go to a service, attend a vigil, or just hold a good thought or observe a moment of silence on this World AIDS Day, reflect also on the ways that racism shapes the epidemic and who we lose because of it. If you care about racial and gender equality, you need to start paying attention to HIV/AIDS. IF you’re concerned about HIV/AIDS, you need to start learning about racism and sexism.
For more on the public health crisis affecting black women, you can watch this video (approximately 27 minutes) which features a discussion with C. Virginia Fields, President of National Black Leadership Commission on AIDS, Monica Sweeney, MD, Assistant Commissioner for the Bureau of HIV/AIDS Prevention and Control of the NYC Department of Health and Mental Hygiene, and Marvelyn Brown.